Telehealth
Telehealth or telemedicine appointments are visits with a provider through video or online messaging services. Using telehealth allows members to safely and more easily access care when they may have a hard time making an in-person visit. It also gives members more options to get the care they need to stay healthy.
$0 Telehealth benefit
Turquoise Care, Presbyterian Senior Care (HMO) Presbyterian MediCare PPO and certain Commercial members can make a telehealth appointment with most in-network providers for $0. Please see the Exclusions section for information about Presbyterian Dual Plus (HMO D-SNP).
This benefit only applies to in-network providers including primary care, urgent care, specialty care and therapy providers. For plans with a deductible, telehealth appointments are 0% cost share after the deductible is met. Not all providers offer telehealth services and it is not advised for all services. We advise members to contact their provider to learn more about their telehealth options.
Important: Please note that there are certain plans that may not qualify for the full benefit or are excluded. To ensure members qualify for this benefit, we advise them to review their member materials or call the Presbyterian Customer Service Center using the number on our Contact Us page. Also, members can access their benefit details online using their myPRES account. Please see the Exclusion section below for more details.
Telehealth Care Options
There are many options for members to get care online or by phone. Our telehealth care options vary by a member’s healthcare needs, provider and insurance plan. Below is a complete list of the services that Presbyterian Health Plan members can use. Please click on the service listed below to learn more.
Service | Provider(s) | Description | Plans and Cost |
|---|---|---|---|
A nationwide network of providers | To diagnose, treat and prescribe medications for minor ailments by video | $0 for most members. See exclusions below* | |
Registered nurse | To speak with a nurse who can answer questions | No charge for Presbyterian Health Plan members | |
Visit any in-network Urgent care including Presbyterian Medical Group | For minor illnesses and injuries | $0 for Presbyterian Health Plan members | |
Visit any in-network primary, specialty or behavioral healthcare provider including Presbyterian Medical Group | For members to meet with their established provider(s) | $0 for most members. See exclusions below* | |
Presbyterian Medical Group provider or care team | Send and get non-urgent medical messages through MyChart | $0 for Presbyterian Health Plan members | |
Behavioral health therapists nationwide | To help treat depression, anxiety, substance use disorder, stress, grief and relationship challenges through text messages | $0 for all Commercial members not on a qualified High Deductible plan |
Please note that members may still need an in-person visit based on their healthcare needs.
Availability of Services and Cost
Availability of services depends on a member’s location. Video Visits and Talk Therapy Sessions, at the will of the provider, are the only telehealth services offered nationwide. All other services must be done in the state where the member is a resident.
Costs depend upon a member’s health insurance. Be sure to check coverage and any out-of-pocket costs before making a telehealth appointment. Members can check their coverage by logging in to their myPRES account or calling the Presbyterian Customer Service Center using the number on the back of their ID card.
*$0 Telehealth Benefit Exclusions
Members on a High Deductible health plan do not qualify for this benefit until they have reached their out-of-pocket maximum. Members on a Presbyterian Dual Plus plan may pay 0% to 20% of the total cost for telehealth benefits. There are some Commercial employer plans that are not included in this benefit.
